URINARY

SYSTEM
Prepared By: Arisa Takagi, PTRP, PT
Edited and Voice Narrated By: Cattleya Marie R. Bragado, PTRP
Topic Outline
• Functions of the Urinary System
• Physiological Anatomy of the Organs of the Urinary System
• Micturition and the Micturition Reflex
• Glomerular Capillary Membrane and its Layers
• Determinants of the Glomerular Filtration Rate
• Mechanism of Autoregulation
• Renal Tubular Reabsorption and Secretion
• Role of Kidneys in Regulating pH
 FUNCTIONS OF THE URINARY SYSTEM
• Excretion of Metabolic Waste Products and Foreign Chemicals
• Regulation of Water and Electrolyte Balances
• Regulation of Body Fluid Osmolality and Electrolyte
Concentrations
• Regulation of Arterial Pressure
• Regulation of Acid-Base Balance
• Regulation of Erythrocyte Production
• Secretion, Metabolism, and Excretion of hormones
• Gluconeogenesis
GENERAL ORGANIZATION OF THE
URINARY SYSTEM
Location and External Anatomy of
the Kidneys
Internal Anatomy and Histology
of the Kidneys
Renal Blood Supply
Nephron CORTICAL NEPHRONS
- nephrons that have glomeruli
located in the outer cortex
- have short loops of Henle that
penetrate only a short distance
into the medulla

JUXTAMEDULLARY NEPHRONS
- nephrons have glomeruli that lie
deep in the renal cortex near
the medulla
- have long loops of Henle that
dip deeply into the medulla, in
some cases all the way to the
tips of the renal papillae
 Transport of Urine from the Kidney
through the Ureters and into the Bladder
Physiological Anatomy of the Urinary
Bladder and Micturition
MICTURITION
- the ANATOMY
process by OF THE
which the
URINARY
urinary bladderBLADDER
empties when
• Body filled
it becomes
2•Main
Neck and Posterior
Steps
Urethra
• Detrusor Muscle
• Trigone
• Internal Sphincter
• External Sphincter
Innervation of the Bladder
Micturition Reflex
 (-) MICTURITION (+) MICTURITION
PELVIC NERVE (-) Detrusor Detrusor Muscles
(PARASYMPATH Muscles and and Internal
INHIBITION STIMULATION
ETIC FIBERS) Internal Sphincter Sphincter
Contraction Contraction
PUDENDAL
NERVE External Sphincter External Sphincter
STIMULATION INHIBITION
(SOMATIC Contraction Relaxation
NERVE FIBERS)
HYPOGASTRIC
NERVE *Little to no Little to no effect*
(SYMAPTHETIC effect* Detrusor (-) Detrusor
FIBERS) STIMULATION Muscles and INHIBITION Muscles and
Internal Sphincter Internal Sphincter
Relaxation Relaxation
Glomerulus and the Glomerular
Capillary Membrane
 Layers of Glomerular Capillary
Membrane
Endothelium
Basement Membrane
Epithelial Cell Layer
- consists
innermost of alayer
meshwork of
- outermost surface
collagen
-- perforated
ALL LAYERS OF THE GLOMERULAR andby proteoglycan
CAPILLARY thousands
WALL of small
have long footlike processes
fibrillae
holes that fenestrae
called have large spaces
PROVIDE A BARRIER TO FILTRATION OF
(podocytes) PLASMA PROTEINS
that encircle
through which large amounts of
the outer
-water
despite
surface ofthe
thepresence
capillariesofwhich is
and small solutes can filter
separated by gaps
fenestrations, called slit
endothelial pores
cell
- effectively prevents filtration of
- Have negative
proteins are charges
richly endowed  with
plasma proteins, because of strong
provide additional restriction to
fixed
negative negative
electricalcharges
chargesthat hinder
associated
filtration of plasma proteins
with the proteoglycans
the passage of plasma proteins
 Factors that Affect Filterability
Size
- Filterability of Solutes is INVERSELY RELATED to their size

Knowing that the molecular weight of

Myoglobin is greater than that of
Glucose, we can assume that
Myoglobin filters(MORE RAPIDLY OR
MORE SLOWLY) _________ in the
glomerular capillary membrane as
compared to Glucose.
 Factors that Affect Filterability
Electrical Charge
- for any given molecular radius (size), positively charged
molecules are filtered much more readily than are negatively
charged molecules
- reason for these is that the negative charges of the basement
membrane and the podocytes provide an important means for
restricting large negatively charged molecules, including the
plasma proteins
Remember: Similar charges REPEL
TRUE OR FALSE: Negatively charged large molecules are filtered
LESS EASILY than positively charged molecules of equal molecular
 Factors that Affect Filterability
EXAMPLE: ALBUMIN (PLASMA PROTEIN)
• Molecular diameter of Albumin: ~ 6 nanometers
• Pores of the glomerular membrane: ~ 8 nanometers

BUT albumin is restricted from filtration because of its

negative charge and the electrostatic repulsion exerted by
negative charges of the glomerular capillary wall
proteoglycans (SIMILAR CHARGES REPEL)
 Determinants of the GFR

1. Sum of the Hydrostatic and Colloid

Osmotic Forces across the glomerular
membrane (Net Filtration Pressure)

2. Glomerular Capillary Filtration Coefficient

 Net Filtration Pressure
Sum of the following forces:
• (1) hydrostatic pressure inside the glomerular capillaries
(glomerular hydrostatic pressure, PG) = which promotes
filtration
• (2) the hydrostatic pressure in Bowman’s capsule (PB)
outside the capillaries = which opposes filtration
• (3) the colloid osmotic pressure of the glomerular
capillary plasma proteins (πG) = which opposes
filtration
• (4) the colloid osmotic pressure of the proteins in
Bowman’s capsule (πB) = which promotes filtration
Positive Net Filtration pressure: fluid
filtration across the glomerular
capillaries
 Net Filtration Pressure

• Increased Bowman’s Capsule Hydrostatic Pressure

Decreases GFR
• Increased Glomerular Capillary Colloid Osmotic
Pressure Decreases GFR
• Increased Glomerular Capillary Hydrostatic Pressure
Increases GFR
 Glomerular Capillary Filtration
Coefficient (Kf )
Product of the following
• Hydraulic Conductivity
- how easily fluid can move through pores
• Surface Area of the Glomerular Capillaries
- surface area that can perform filtration

Increased Kf raises GFR

Decreased Kf reduces GFR
 Mechanism of Autoregulation

Autoregulation in the Kidneys: maintain a relatively

constant GFR and to allow precise control of renal
excretion of water and solutes despite changes in
arterial (or blood) pressure

Without Autoregulation: Increased arterial pressure

will result to increased GFR and increased urine flow
of more than 30 fold than normal, resulting to
depletion of blood volume
 Mechanism of Autoregulation

Myogenic Autoregulation
• Myogenic Mechanism: ability of individual blood vessels
to resist stretching during increased arterial pressure
Contraction
prevents
Movement excessive Prevents
↑ Arterial of Ca++ to excessive ↑ in
stretch of the
Pressure: ↑ the smooth Renal Blood Flow
vessel and
Wall Tension/ mm cells: and GFR
RAISES
Stretch contraction vascular
resistance
 Mechanism of
Autoregulation
Tubuloglomerular Feedback
Renin-Angiotensin-
Aldosterone
Mechanism
Hormonal and Autacoid Control of Renal
Circulation
Hormones or autacoids that cause
VASOCONSTRICTION, decrease GFR and renal blood
flow:
• Norepinephrine
• Epinephrine
• Endothelin
Hormonal and Autacoid Control of Renal
Circulation
Hormones or autacoids that cause VASODILATION,
increase GFR and renal blood flow:
• Endothelial-Derived Nitric Oxide
• Prostaglandins
• Bradykinin
• Dopamine
Hormonal and Autacoid Control of Renal
Circulation
Atrial natriuretic peptide (ANP)
vasodilation of afferent arterioles and, to a lesser
extent, vasoconstriction of efferent arterioles =
INCREASE IN RENAL BLOOD FLOW AND GLOMERULAR
FILTRATION RATE
 Renal Tubular
Reabsorption and
Secretion
Proximal Tubule
Thin Descending Loop of Henle
Thick Ascending Loop of Henle
Early Distal Tubule
Late Distal Tubule and Collecting Tubule
Medullary Collecting Duct
Antidiuretic Hormone
References
•Guyton, A., and Hall, J. (2011). Textbook of
Medical Physiology, 13thed.
•Snell, R. (2012). Clinical Anatomy by Regions,
9thed.
•VanPutte, C., Regan, J., and Russo, A. (2014).
Seeley’s Anatomy and Physiology, 10thed.